title: Motor recovery of the ipsilesional upper limb in subacute stroke.
abstract: OBJECTIVE
  To investigate the time-related changes in motor performance of the ipsilesional upper limb in subacute poststroke patients by using clinical and kinematic assessments.
  
  
  METHODS
  Observational, longitudinal, prospective, monocentric study.
  
  
  METHODS
  Physical medicine and rehabilitation department.
  
  
  METHODS
  Stroke patients (n=19; mean age, 62.9y) were included less than 30 days after a first unilateral ischemic/hemorrhagic stroke. The control group was composed of age-matched, healthy volunteers (n=9; mean age, 63.1y).
  
  
  METHODS
  Clinical and kinematic assessments were conducted once a week during 6 weeks and 3 months after inclusion. Clinical measures consisted of Fugl-Meyer Assessment, Box and Block Test (BBT), Nine-Hole Peg Test (9HPT), and Barthel Index. We used a 3-dimensional motion recording system during a reach-to-grasp task to analyze movement smoothness, movement time, and peak velocity of the hand. Healthy controls performed both clinical (BBT and 9HPT) and kinematic evaluation within a single session.
  
  
  METHODS
  BBT and 9HPT.
  
  
  RESULTS
  Recovery of ipsilesional upper arm capacities increased over time and leveled off after a 6-week period of rehabilitation, corresponding to 9 weeks poststroke. At study discharge, patients demonstrated similar ipsilesional clinical scores to controls but exhibited less smooth reaching movements. We found no effect of the hemispheric side of the lesion on ipsilesional motor deficits.
  
  
  CONCLUSIONS
  Our findings provide evidence that ipsilesional motor capacities remain impaired at least 3 months after stroke, even if clinical tests fail to detect the impairment. Focusing on this lasting ipsilesional impairment through a more detailed kinematic analysis could be of interest to understand the specific neural network underlying ipsilesional upper-limb impairment.
authors.affiliation: Movement to Health Laboratory, EuroMov, Montpellier-1 University, Montpellier, France.
authors.forename: Julien
authors.initials: J
authors.lastname: Metrot
authors.forename: Jerome
authors.initials: J
authors.lastname: Froger
authors.forename: Isabelle
authors.initials: I
authors.lastname: Hauret
authors.forename: Denis
authors.initials: D
authors.lastname: Mottet
authors.forename: Liesjet
authors.initials: L
authors.lastname: van Dokkum
authors.forename: Isabelle
authors.initials: I
authors.lastname: Laffont
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000502:physiology*; D011446:Prospective Studies; D020127:Recovery of Function; D020521:Stroke / Q000503:physiopathology*; D000071939:Stroke Rehabilitation; D013647:Task Performance and Analysis; D034941:Upper Extremity / Q000503:physiopathology*
keywords: 9HPT; BBT; Box and Block Test; FMA; Fugl-Meyer Assessment; Ipsilateral; Kinematics; LHD; NVP; Nine-Hole Peg Test; RHD; Reach-to-grasp; Recovery; Rehabilitation; Stroke; UL; analysis of variance with repeated measures; left hemisphere damaged; number of velocity peaks; rANOVA; right hemisphere damaged; upper limb